News & Analysis

August 14, 2019
HIM Briefings

CMS’ inpatient-only rule seems simple enough on the surface—certain specified procedures, all noted in the OPPS inpatient-only list, must be performed on an inpatient basis regardless of the patient’s expected length of stay. But as with anything in healthcare, implementing this rule is hardly simple, and many organizations continue to misapply it and lose revenue as a result. Get expert answers to common inpatient-only compliance stumbling blocks.

August 14, 2019
News & Insights

Q: What are some examples of programs that address social determinants of health (SDoH) in an Accountable Care Organization (ACO) setting?

August 13, 2019
News & Insights

Oversight of the practice of case management is a complex process. A number of moving parts must be factored in, including education, credentialing, and professional qualifications.

August 12, 2019
News & Insights

Q: What is the difference between a Medicare claim appeal (redeterminiation) versus reopening of a claim?

August 9, 2019
News & Insights

A Kentucky community health center paid hackers $70,000 in bitcoin to regain access to its computer systems after suffering its second ransomware attack in three months. 

August 9, 2019
News & Insights

 Q: A diabetic patient is diagnosed with a gangrenous decubitus ulcer of the left heel and admitted to the hospital for treatment. If the provider documents an association between diabetes and the decubitus ulcer, which condition should be sequenced as the principal diagnosis?

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